• Jacob D Bolzenius, Carmen S Velez, Jeffrey D Lewis, Erin D Bigler, Benjamin S C Wade, Douglas B Cooper, Jan E Kennedy, Matthew W Reid, John L Ritter, Gerald E York, and David F Tate.
• Missouri Institute of Mental Health, University of Missouri-St Louis, Berkeley, Missouri (Drs Bolzenius, Wade, and Tate and Ms Velez); Department of Neurology, Uniformed Services University of the Health Sciences School of Medicine, Bethesda, Maryland (Dr Lewis); Department of Psychology and Neuroscience Center, Brigham Young University, Provo, Utah (Dr Bigler); Defense and Veterans Brain Injury Center, San Antonio, Texas (Drs Cooper, Kennedy, and Reid); Department of Radiology, Brooke Army Medical Center, San Antonio, Texas (Dr Ritter); and Alaska Radiology Associates, TBI Imaging and Research, Anchorage, Alaska (Dr York).
• J Head Trauma Rehabil. 2018 Nov 1; 33 (6): 393-402.

ObjectiveUse diffusion tensor imaging to investigate white matter microstructure attributable to mild TBI (mTBI) and/or posttraumatic stress disorder (PTSD).ParticipantsTwenty-seven individuals with mTBI only, 16 with PTSD only, 42 with mTBI + PTSD, and 43 service members who sustained orthopedic injury.DesignDescriptive cross-sectional study.Main MeasuresClinical diffusion tensor imaging sequence to assess fractional anisotropy, mean, axial, and radial diffusivity within selected regions of interest.ResultsCorrected analyses revealed a pattern of lower white matter integrity in the PTSD group for several scalar metrics. Regions affected included primarily right hemisphere areas of the internal capsule. These differences associated with the PTSD only cohort were observed in relation to all 3 comparison groups, while the mTBI + PTSD group did not exhibit any notable pattern of white matter abnormalities.ConclusionResults suggest that lower resolution scan sequences are sensitive to post-acute abnormalities associated with PTSD, particularly in the right hemisphere. In addition, these findings suggest that ongoing PTSD symptoms are associated with differences in white matter diffusion that are more readily detected in a clinical scan sequence than mTBI abnormalities. Future studies are needed to prospectively assess service members prior to onset of injury to verify this pattern of results.

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